Next week economist Andrew Dilnot will publish his long-awaited proposals on how we should fund social care. Given the current care crisis, that question is a crucial one. But there is an even greater challenge than that: tackling the entrenched isolation of over a million pensioners.

During the course of our work over the last eighteen months we have met many older people completely cut off from community. In Leeds we visited Mrs Thomas, 72, a former teacher who lives in a house which is falling apart, devoid of furniture and damaging to her health. The only child of an only child, left by her husband in her late 20s, Mrs Scott has no immediate nor extended family. Her human contact is limited to half an hour a week – the neighbour who takes her to Morrisons.

Mrs Scott is no ‘outlier’. The statistics are shocking but all too familiar. Over a million people aged 65 and over report feeling lonely often or always. A similar number say they feel trapped in their homes. Half of all older people cite television as their main form of company. And, according to the latest figures, an estimated 500,000 pensioners spend Christmas day alone.

We are talking about men and women totally separated from society – who never set foot out of the door because last time they did they were harassed by local kids. People whose connection to the wider world is restricted to a quick call from a relative the other side of the country or a palliative care nurse who drops in to check medication.

Elderly isolation is by definition a hidden, behind-closed-doors problem. But it also surfaces, and in unlikely places. Take the juniors doctors who report 85 year-old widowers, living alone, who present regularly at accident and emergency departments wearing summer clothes in the winter. Or ambulance crews who turn up to collect a collapsed 70 year-old carer and find her and the husband she looks after so isolated they have no option but to put both of them in the back of the ambulance.

The root causes of this tragedy are complex. On the one hand there’s the loss associated with the normal life course – the death of a spouse, the loss of a parent, the experience of outliving neighbours and friends. But on the other hand there is ‘chronic loneliness’, where dysfunctional relationships and exclusion from society characterise an individual’s life for many years.

We are well aware of the damage of family breakdown upon children. But what we are now beginning to see is the impact of family breakdown at the other end of life. We are beginning to see the true effects of estrangement.

Yet in our report, Age of Opportunity, published today, we set out a way through this poverty. Re-engaging the most isolated elderly back into community is a task which is not only vital but possible. There is every reason to challenge the defeatism which has paralysed public policy for too long.

Many older people living in severe isolation simply haven’t been offered the hope of anything better. During the course of the CSJ’s work we have seen the most outstanding charities reaching out to older people and changing lives. At a befriending charity we visited in Kent, volunteers matched to older people have become their official ‘next of kin’. They have been there when no one else has. We need to give these charities all the help they can get. We need them in every neighbourhood, covering every street.

Another reason for optimism is that many of this ‘missing million’ are in fact known to statutory bodies. In many cases social workers, GPs or police officers are the only human beings the most isolated older people come into contact with. But having ‘come onto the radar’, as it were, what needs to happen is for those professionals to partner with the charities and community groups who can provide what they cannot: namely, friendship.

For this to happen on the kind of scale needed requires a level of outreach more proactive than anythingwe’ve seen before. And if society is serious about responding to that challenge, we could really begin to turn the tide. In one of the most deprived wards in Manchester, one charity we visited accompanies neighbourhood police officers as they go door-to-door. What the charity says about this approach really captures the kind of commitment we are going to need: ‘Until we've knocked on every door we won't know we've gotten to people.’